Defining and grouping children's therapeutic footwear and criteria for their prescription: an international expert Delphi consensus study

Respectful Children's Shoes: A Systematic Review

BACKGROUND

Child footwear, both in pathologies and in normal situations, can affect the foot in various ways depending on its characteristics. Below, some features of child footwear are described, and how they can influence the foot, including suitable size, shape and design, flexibility, and transpirable material; inadequate footwear includes situations with flat foot, equine foot, and hammer toes. It is important to highlight that each child is unique and may have different footwear needs. In case of specific pathologies or concerns, it is recommended to consult a specialist in podology or foot medicine for personalized assessment and recommendations.

METHODS

The present systematic review was conducted in accordance with the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

RESULTS

Children's footwear must adapt to all stages of children's growth, starting from when they begin to walk, to promote the correct evolution of their musculoskeletal system. For up to six months, they do not need to wear shoes; socks and similar clothing are enough to warm your feet like a second skin. The flexibility of respectful footwear is essential between six months and three or four years. From that age onwards, the soles can be somewhat thicker, and the buttress can have a certain firmness, but the shoes should remain flexible.

CONCLUSIONS

Eco-friendly footwear, which typically comes from small businesses and factories, is sometimes described as "ergonomic footwear". However, there is some reluctance towards this term. When choosing this type of footwear for children, it is important to not just look at the label; rather, one should verify that it meets all the necessary characteristics to be considered respectful.

Evidence-based rehabilitation medicine: definition, foundation, practice and development

To determine the definition, foundation, practice, and development of evidence-based rehabilitation medicine (EBRM) and point out the development direction for EBRM. Retrieve the database of PubMed, Cochrane Library, Embase, China national knowledge infrastructure (CNKI), Wanfang, and China science and technology journal database (CSTJ). The search was conducted from the establishment of the database to June 2023. The key words are "rehabilitation medicine and evidence based" in Chinese and English. After reading the abstract or full text of the literature, a summary analysis is conducted to determine the definition, foundation, practice, and development of EBRM. A total of 127 articles were included. The development of 14 sub majors in EBRM are not balanced, evidence-based musculoskeletal rehabilitation medicine (EBMRM) (31 articles, mainly focuses on osteoarthritis, osteoporosis and musculoskeletal pain), evidence-based neurorehabilitation medicine (EBNM) (34 articles, mainly concentrated in stroke, traumatic brain injury and spinal cord injury) and evidence-based education rehabilitation medicine (EBEDRM) (17 articles, mainly focuses on educational methodology), evidence-based nursing rehabilitation medicine (EBNRM) (2 articles), evidence-based engineering rehabilitation medicine (EBENRM) (7 articles), evidence-based traditional Chinese rehabilitation medicine (EBTCRM) (3 articles), evidence-based internal rehabilitation medicine (EBIRM) (11 articles), evidence-based intensive care rehabilitation medicine (EBICRM) (4 articles), evidence-based oncology rehabilitation medicine (EBORM) (6 articles), evidence-based physical therapy medicine (EBPTM) (3 articles), evidence-based cardiopulmonary rehabilitation medicine (EBCRM) (6 articles), evidence-based speech therapy medicine (EBSTM)/evidence-based occupation therapy medicine (EBOTM)/evidence-based geriatric rehabilitation medicine (EBGRM) (1 article). The EBMRM, EBNM and EBEDRM are relatively well developed. The development of EBNRM, EBENRM, EBTCRM, EBIRM, EBICRM, EBGRM, EBORM, EBCRM, EBPTM, EBSTM and EBOTM is relatively slow, indicating these eleven fields should be pay more attention in future.

Parents, health professionals and footwear stakeholders' beliefs on the importance of different features of young children's footwear: a qualitative study

Background

A small but building pool of evidence of the impact of footwear on children’s function means understanding the different beliefs of stakeholders about footwear key features and flexibility is critical for translation into recommendations and to support parents and caregivers in purchasing footwear for their children. Therefore, this research aimed to describe how different stakeholders (health professionals, parents, and footwear industry representatives) described the importance of flexibility and other footwear features for young children.

Methods

This qualitative study was nested within an international modified Delphi online survey. Participants responded to open-ended questions about footwear component flexibility and asked if and why flexibility in these areas were important. Participants also described any other important footwear features. Inductive thematic analysis was used to generate themes.

Results

There were 121 responses from three stakeholder groups including health professionals (n = 90), parents of young children (n = 26) and footwear industry representatives (n = 5). Overarching themes described by participants included developmental impacts of footwear, therapeutic impact and how footwear may play a role in function.

Conclusion

There were key differences in how stakeholders viewed footwear and any perceived benefits of footwear components, much of which was not backed with empirical evidence. It was also identified that health professionals are using footwear within treatment recommendations. This work highlights the importance of understanding circumstances in which footwear may have a therapeutic impact or be the first line of treatment for children with complex foot needs. This is the first step in developing contemporary footwear recommendations for parents and caregivers.

Young children's footwear taxonomy: An international Delphi survey of parents, health and footwear industry professionals

OBJECTIVE

There is little consistency between commercial grade footwear brands for determining shoe sizing, and no universally accepted descriptors of common types or features of footwear. The primary aim of this research was to develop a footwear taxonomy about the agreed types of footwear commonly worn by children under the age of six. Secondary aims were to gain consensus of the common footwear features, when different types of footwear would be commonly worn, common terms for key footwear parts, and how movement at some of these footwear parts should be described.

MATERIALS AND METHODS

Opinions were collected through a three-round modified Delphi international online survey from parents, health professionals, researchers, and footwear industry professionals. The first survey displayed generic pictures about different footwear types and asked participants to provide a grouping term, when the footwear would be worn (for what type of activity) and any grouping features. The second and third rounds presented consensus and gathered agreement on statements.

RESULTS

There were 121 participants who provided detailed feedback to open-ended questions. The final round resulted in consensus and agreement on the names of 14 different footwear types, when they are commonly worn and their common features. Participants also reached consensus and agreement on the terms heel counter to describe the back part of footwear and fixtures as the collective term for features allowing footwear adjustability and fastening. They also agreed on terms to quantify the flexibility at footwear sole (bend or twist) or the heel counter.

CONCLUSION

This first taxonomy of children's footwear represents consensus amongst different stakeholders and is an important step in promoting consistency within footwear research. One shoe does not fit all purposes, and the recommendations from this work help to inform the next steps towards ensuring greater transparency and commonality with footwear recommendations.